The objectives of the clinical investigation unit of the Bronx Comprehensive Sickle Cell Center (BCSCC) are to optimize care and to serve as a resource that facilitates careful research into the manifestations and pathophysiology of sickle cell disease. This will be accomplished through a balanced program integrating medical, psychological, social and educational needs and assessments and interventions in model settings for specialized patient care. Medical office visits by appointment with specific physicians rather than the traditional clinic setting, fosters increased compliance, more timely health care maintenance, and greater opportunities for patient education. Areas of investigation include: (1) pain assessment and therapy in sickle cell disease and toward acute and chronic painful events specifically targeting patients with high pain rates and corresponding high utilization of hospital-based facilities; and 92) genetic, molecular, and cellular determinants of clinical symptoms in sickle cell disease. These studies should afford the acquisition of knowledge regarding clinical manifestations which should permit the discovery of better ways of diagnosis and management which can be applicable to patients in other centers. The Day Hospital is a model specialized unit for treatment of acute sickle pain that fosters prompt, consistent, and aggressive therapy to optimize relief of pain while serving as a conduit for education of health care providers and for research.